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Clinical Characteristics of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Korean Children: A Multicenter Retrospective Study
Mycoplasma pneumoniae is a major causative pathogen of community-acquired pneumonia in children, and the treatment of choice is macrolides. There is an increasing trend in reports of refractory clinical responses despite macrolide treatment due to the emergence of macrolide-resistant M. pneumoniae....
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8779611/ https://www.ncbi.nlm.nih.gov/pubmed/35054002 http://dx.doi.org/10.3390/jcm11020306 |
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author | Choi, Yun Jung Chung, Eun Hee Lee, Eun Kim, Chul-Hong Lee, Yong Ju Kim, Hyo-Bin Kim, Bong-Seong Kim, Hyung Young Cho, Yoojung Seo, Ju-Hee Sol, In Suk Sung, Myongsoon Song, Dae Jin Ahn, Young Min Oh, Hea Lin Yu, Jinho Jung, Sungsu Lee, Kyung Suk Lee, Ju Suk Jang, Gwang Cheon Jang, Yoon-Young Chung, Hai Lee Choi, Sung-Min Han, Man Yong Shim, Jung Yeon Kim, Jin Tack Kim, Chang-Keun Yang, Hyeon-Jong Suh, Dong In |
author_facet | Choi, Yun Jung Chung, Eun Hee Lee, Eun Kim, Chul-Hong Lee, Yong Ju Kim, Hyo-Bin Kim, Bong-Seong Kim, Hyung Young Cho, Yoojung Seo, Ju-Hee Sol, In Suk Sung, Myongsoon Song, Dae Jin Ahn, Young Min Oh, Hea Lin Yu, Jinho Jung, Sungsu Lee, Kyung Suk Lee, Ju Suk Jang, Gwang Cheon Jang, Yoon-Young Chung, Hai Lee Choi, Sung-Min Han, Man Yong Shim, Jung Yeon Kim, Jin Tack Kim, Chang-Keun Yang, Hyeon-Jong Suh, Dong In |
author_sort | Choi, Yun Jung |
collection | PubMed |
description | Mycoplasma pneumoniae is a major causative pathogen of community-acquired pneumonia in children, and the treatment of choice is macrolides. There is an increasing trend in reports of refractory clinical responses despite macrolide treatment due to the emergence of macrolide-resistant M. pneumoniae. Early discrimination of macrolide-refractory M. pneumoniae pneumonia (MrMP) from macrolide-sensitive M. pneumoniae pneumonia (MSMP) is vital; however, testing for macrolide susceptibility at the time of admission is not feasible. This study aimed to identify the characteristics of MrMP in Korean children, in comparison with those of MSMP. In this multicenter study, board-certified pediatric pulmonologists at 22 tertiary hospitals reviewed the medical records from 2010 to 2015 of 5294 children who were hospitalized with M. pneumoniae pneumonia and administered macrolides as the initial treatment. One-way analysis of variance and the Kruskal-Wallis test were used to compare differences between groups. Of 5294 patients (mean age, 5.6 years) included in this analysis, 240 (4.5%), 925 (17.5%), and 4129 (78.0%) had MrMP, macrolide-less effective M. pneumoniae pneumonia, and MSMP, respectively. Compared with the MSMP group, the MrMP group had a longer fever duration, overall (13.0 days) and after macrolide use (8.0 days). A higher proportion of MrMP patients had respiratory distress, pleural effusion, and lobar pneumonia. The mean aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and C-reactive protein levels were the highest in the MrMP group, along with higher incidences of extrapulmonary manifestations and atelectasis (during and post infection). Pre-existing conditions were present in 17.4% (n = 725/4159) of patients, with asthma being the most common (n = 334/4811, 6.9%). This study verified that MrMP patients show more severe initial radiographic findings and clinical courses than MSMP patients. MrMP should be promptly managed by agents other than macrolides. |
format | Online Article Text |
id | pubmed-8779611 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-87796112022-01-22 Clinical Characteristics of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Korean Children: A Multicenter Retrospective Study Choi, Yun Jung Chung, Eun Hee Lee, Eun Kim, Chul-Hong Lee, Yong Ju Kim, Hyo-Bin Kim, Bong-Seong Kim, Hyung Young Cho, Yoojung Seo, Ju-Hee Sol, In Suk Sung, Myongsoon Song, Dae Jin Ahn, Young Min Oh, Hea Lin Yu, Jinho Jung, Sungsu Lee, Kyung Suk Lee, Ju Suk Jang, Gwang Cheon Jang, Yoon-Young Chung, Hai Lee Choi, Sung-Min Han, Man Yong Shim, Jung Yeon Kim, Jin Tack Kim, Chang-Keun Yang, Hyeon-Jong Suh, Dong In J Clin Med Article Mycoplasma pneumoniae is a major causative pathogen of community-acquired pneumonia in children, and the treatment of choice is macrolides. There is an increasing trend in reports of refractory clinical responses despite macrolide treatment due to the emergence of macrolide-resistant M. pneumoniae. Early discrimination of macrolide-refractory M. pneumoniae pneumonia (MrMP) from macrolide-sensitive M. pneumoniae pneumonia (MSMP) is vital; however, testing for macrolide susceptibility at the time of admission is not feasible. This study aimed to identify the characteristics of MrMP in Korean children, in comparison with those of MSMP. In this multicenter study, board-certified pediatric pulmonologists at 22 tertiary hospitals reviewed the medical records from 2010 to 2015 of 5294 children who were hospitalized with M. pneumoniae pneumonia and administered macrolides as the initial treatment. One-way analysis of variance and the Kruskal-Wallis test were used to compare differences between groups. Of 5294 patients (mean age, 5.6 years) included in this analysis, 240 (4.5%), 925 (17.5%), and 4129 (78.0%) had MrMP, macrolide-less effective M. pneumoniae pneumonia, and MSMP, respectively. Compared with the MSMP group, the MrMP group had a longer fever duration, overall (13.0 days) and after macrolide use (8.0 days). A higher proportion of MrMP patients had respiratory distress, pleural effusion, and lobar pneumonia. The mean aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and C-reactive protein levels were the highest in the MrMP group, along with higher incidences of extrapulmonary manifestations and atelectasis (during and post infection). Pre-existing conditions were present in 17.4% (n = 725/4159) of patients, with asthma being the most common (n = 334/4811, 6.9%). This study verified that MrMP patients show more severe initial radiographic findings and clinical courses than MSMP patients. MrMP should be promptly managed by agents other than macrolides. MDPI 2022-01-08 /pmc/articles/PMC8779611/ /pubmed/35054002 http://dx.doi.org/10.3390/jcm11020306 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Choi, Yun Jung Chung, Eun Hee Lee, Eun Kim, Chul-Hong Lee, Yong Ju Kim, Hyo-Bin Kim, Bong-Seong Kim, Hyung Young Cho, Yoojung Seo, Ju-Hee Sol, In Suk Sung, Myongsoon Song, Dae Jin Ahn, Young Min Oh, Hea Lin Yu, Jinho Jung, Sungsu Lee, Kyung Suk Lee, Ju Suk Jang, Gwang Cheon Jang, Yoon-Young Chung, Hai Lee Choi, Sung-Min Han, Man Yong Shim, Jung Yeon Kim, Jin Tack Kim, Chang-Keun Yang, Hyeon-Jong Suh, Dong In Clinical Characteristics of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Korean Children: A Multicenter Retrospective Study |
title | Clinical Characteristics of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Korean Children: A Multicenter Retrospective Study |
title_full | Clinical Characteristics of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Korean Children: A Multicenter Retrospective Study |
title_fullStr | Clinical Characteristics of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Korean Children: A Multicenter Retrospective Study |
title_full_unstemmed | Clinical Characteristics of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Korean Children: A Multicenter Retrospective Study |
title_short | Clinical Characteristics of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Korean Children: A Multicenter Retrospective Study |
title_sort | clinical characteristics of macrolide-refractory mycoplasma pneumoniae pneumonia in korean children: a multicenter retrospective study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8779611/ https://www.ncbi.nlm.nih.gov/pubmed/35054002 http://dx.doi.org/10.3390/jcm11020306 |
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